AMH水平对年轻不孕女性行IVF/ICSI治疗后胚胎质量及鲜胚移植临床结局的影响  

Effect of AMH Levels on Embryo Quality and Clinical Outcomes of Fresh Embryo Transfer in Young Infertile Female Patients Undergoing IVF/ICSI Treatment

作　　者：毛佳婷 余柯达[1] 柴娟[1] 包云 师帅[1] MAO Jiating;YU Keda;CHAI Juan(Center of Reproductive Medicine,Jinhua People′s Hospital,Zhejiang 321000,China)

机构地区：[1]金华市人民医院生殖医学中心,321000

出　　处：《医学研究杂志》2024年第9期147-151,共5页Journal of Medical Research

基　　金：浙江省金华市科学技术研究计划项目(2020-4-038)。

摘　　要：目的探讨不同抗苗勒激素(anti-Müllerian hormone,AMH)水平对行体外受精-卵胞浆内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)治疗的年轻不孕女性患者胚胎质量及鲜胚移植临床结局的影响。方法回顾性分析2020年1月~2021年12月在金华市人民医院生殖中心行IVF/ICSI治疗的528例年轻女性不孕患者的临床资料,根据血清AMH水平分为3组,即低AMH组(n=93)、中AMH组(n=273)和高AMH组(n=162),比较3组患者的基线资料、实验室指标和临床结局;采用多重线性回归分析判断AMH与各实验室指标的相关性;采用Logistic回归分析校正3组基线资料不同对临床结局的影响。结果多重线性回归分析结果表明,AMH水平是影响获卵数、正常受精率的独立因素。AMH水平与获卵数(β=0.630,95%CI:0.405~0.854,P<0.05)呈正相关,与正常受精率(β=-1.965,95%CI:-2.897~1.033,P<0.05)呈负相关。Logistic回归分析结果显示,不同AMH组的临床结局差异无统计学意义(P>0.05)。结论在年轻不孕女性患者中,AMH是预测获卵数及正常受精率的独立影响因素,AMH是反映卵巢储备能力的较好指标,但在鲜胚移植中AMH无明显的预测临床结局的能力,即使是低AMH者,只要获得胚胎也能获得满意的妊娠结局,高AMH者也并不意味着可获得更好的妊娠结局。Objective To investigate the impact of different levels of anti-Müllerian hormone(AMH)on embryo quality and clinical outcomes of fresh embryo transplantation in young infertile female patients undergoing treatment with in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI).Methods The clinical data of 528 young infertile female patients who underwent IVF/ICSI treatment at the Center of Reproductive Medicine,Jinhua People′s Hospital from January 2020 to December 2021 were retrospectively analyzed,and they were divided into three groups based on serum AMH levels:low AMH group(n=93),medium AMH group(n=273)and high AMH group(n=162).Baseline information,laboratory indicators,and clinical outcomes of the three groups were compared.Multiple linear regression analysis was used to determine the correlation between AMH and various laboratory indicators,Logistic regression analysis was adopted to correct for the impact of different baseline information on clinical outcomes in three groups.Results The results of multiple linear regression analysis showed that the level of AMH was an independent factor affecting the number of retrieved oocytes and normal fertilization rate,and positively correlated to the number of retrieved oocytes(β=0.630,95%CI:0.405-0.854,P<0.05),and negatively correlated with normal fertilization rate(β=-1.965,95%CI:-2.897-1.033,P<0.05).The results of Logistic regression analysis showed that there was no significant difference in clinical outcomes among different AMH groups(P>0.05).Conclusion AMH is an independent influencing factor for predicting the number of retrieved oocytes and normal fertilization rate in young infertile female patients,and AMH is a good indicator of ovarian reserve capacity,but it has no significant ability to predict clinical outcomes in fresh embryo transplantation.Even those with low AMH can achieve satisfactory pregnancy outcomes as long as they obtain embryos,and high AMH does not necessarily mean they can achieve better pregnancy outcomes.

关 键 词：AMH IVF/ICSI 胚胎发育 临床结局 

分 类 号：R711[医药卫生—妇产科学]